The managed care marketplace cannot reach its full potential without informed consumers who can select their health care based on quality as well as price. Enormous resources from both the public and private sector have been committed to developing and disseminating report cards that compare health plans so that consumers can be better informed. To-date, results of the impact of report cards have been modest at best. The limited effectiveness of report cards may be due to murky market characteristics in which the health plan is not a meaningful unit of comparison for consumers, and it may be due to weak study designs that have been employed to test the effects. The current proposal tests the effect of a report card on employees who are choosing unique care systems (rather than health plans). The study design is a randomized controlled field trial. The sample consists of 400 employees from eight companies who participate in a business coalition, the Buyers Health Care Action Group in Minnesota. The intervention is receipt of a report card that compares care system choices on both quality and cost. The main outcome measures are (1) increased knowledge, (2) increased choice of higher quality care systems, and (3) report card influence on switching care systems.